Program Operations Manual System (POMS)

In general, the Act requires a Continuing Disability Review (CDR) 12 months after the birth of an infant whose LBW was material to the disability determination. Most often, this will be under listing 100.04. LBW is “material” if considering the LBW would result in a determination of “disabled,” and if not considering the LBW would result in a determination of “not disabled.”

NOTE: Although most LBW infants are born prematurely, premature birth is not required to satisfy listing 100.04.

LBW infants may experience problems related to their prematurity and associated perinatal complications. The lower the infant’s birth weight, the greater is the likelihood and severity of problems. Such problems can require lengthy initial hospitalizations; are often followed by the need for re-hospitalization; and can result in long-term complications involving the infant’s growth, developmental patterns, physical health, and age-appropriate functioning. LBW infants who are additionally small for gestational age under SSA’s rules (i.e., the table in listing 100.04B) are also more likely to have long-term complications.

Evidence about such medical problems and complications may support a later diary date. It is not necessary to develop for such evidence if you already have enough information to allow the case. However, if such evidence is in the file, you must consider it when setting the CDR diary. Medical conditions that require a longer diary are discussed in DI 25235.006B.2.a.

When LBW is not material to a finding of disability, set a MIE, MIP, or MINE diary, as appropriate, based on all evidence in file and clinical judgment regarding the probability and timing of medical improvement. If a MIE diary is applicable, assign Reason Code A or B, as appropriate, per DI 26525.025B.2.

For most LBW infants, the presence of one or more of these conditions directs a later diary date, because they tend to be associated with a poorer long-term prognosis. It is not necessary to develop for evidence of these conditions, but if the evidence is in file at adjudication, you must consider it in setting the CDR diary. See DI 25235.006B.1.b. and DI 25235.006B.1.c. for specific instructions for each weight range.

Follow the chart below to set minimum diary dates for infants who are found disabled under listing 100.04A (birth weight of less than 1200 grams). The DDS consultant may decide that longer diaries are appropriate in some cases.

Although these infants have higher birth weights than those described in listing 100.04A, they are small for gestational age under SSA’ rules, a condition that tends to be associated with a poor long-term prognosis. For infants found disabled under listing 100.04B (birth weight between 1250 grams – 2000 grams), set a minimum diary date at 24 months of chronological age. The DDS consultant may decide that longer diaries are appropriate in some cases.

See the table in listing 100.04B to determine “small for gestational age” under our rules.

Problems such as intraventricular hemorrhage and retinopathy of prematurity are less common in gestationally more mature infants. When they are present, however, take this information into account when setting the diary date.